57 TRADE MARKS REGULATIONS, 1970 (L.I. 667) ....................................................................................................................................... ....................................................... hereby request that my (or our) names ..................................... may be entered in the Register of Trade Marks as proprietor ........................................ of trade mark(s) No. ..........................† in Class ..................................... as from the (b) .......................................................................................... I am (or We are) entitled to the trade mark(s) .......................................................................................... by virtue of (c) ...................................................................................................................................... ...................................................... (d) The trade mark at the time of the assignment was (d) (not) used in a business in the goods in question, and the assignment (d) (did not take) place on or after the appointed day otherwise than in connection with the goodwill of a business in the goods, (d) and there is sent herewith a copy of the Registrar's direction to advertise the assignment, a copy of each of the advertisements complying therewith, and a statement of the dates of issue of any publications containing them. Dated this ...................................................... 19....................................................... day of ................................., (Signature) ........................................................................... To The Registrar of Trade Marks, Registrar-General's Department, P.O. Box 118, Accra. _______________ A request for the entry of an address for service of the subsequent proprietor may be made on Form TM - No. 31 if it accompanies this Form. (a) Here insert full name, trade or business address, nationality and description. † Additional numbers may be given in a signed schedule on the back of the Form. (b) Date of acquisition of proprietorship. (c) Here insert full particulars of the instrument of assignment or transmission, if any or statement of case.